| NPI | 1205819661 |
|---|---|
| Former Name | PAMELA MARIE DESELM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO DR.0055858) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 54123901205) |
| 208000000X Pediatrics (Licence: WI 45172) | |
| 208000000X Pediatrics (Licence: OR MD150351) | |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2017-10-31 |