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 |