| 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 |