| NPI | 1770524621 |
|---|---|
| Former Name | PAMELA DAWN BLACKMON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: TX DT01201) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: LA 32) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2007-07-08 |