| NPI | 1912540808 |
|---|---|
| Former Name | MADELEINE CLAIRE KEATON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: LA 321005) |
| Additional Taxonomies | 2086S0120X Surgery Pediatric Surgery (Licence: TX PA13092) |
| 363AS0400X Physician Assistant Surgical (Licence: TX PA13092) | |
| 363AS0400X Physician Assistant Surgical (Licence: LA 321005) | |
| Enumeration Date | 2019-10-23 |
| Last Update Date | 2022-05-13 |