NPI | 1104094028 |
---|---|
Former Name | PAMELA FAYE BLAKELY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 9600483) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 9600483) |
Enumeration Date | 2008-02-13 |
Last Update Date | 2024-09-03 |