| NPI | 1912187972 |
|---|---|
| Former Name | CASEY MAHONEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 2514) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085.003104) |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2021-11-30 |