NPI | 1316925886 |
---|---|
Former Name | PAMELA BURWELL |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 1915) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2006-01-05 |
Last Update Date | 2016-06-23 |