NPI | 1568912202 |
---|---|
Former Name | KEATON MARSH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61095906) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 6766) |
Enumeration Date | 2016-10-05 |
Last Update Date | 2023-08-02 |