| NPI | 1093740037 |
|---|---|
| Former Name | PAMELA NICHOLSON BROUSSARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NH 9351) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX J1473) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2016-01-14 |