| NPI | 1093031585 |
|---|---|
| Former Name | PAMELA JANE BIRD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine (Licence: KS 04-37177) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 0437177) |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2020-02-25 |