| 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 | 2023-06-05 |