| NPI | 1740542588 |
|---|---|
| Former Name | PAMELA R WATERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036155817) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 27488) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2023-08-10 |