| NPI | 1821191180 |
|---|---|
| Former Name | PAMELA LOUISE BERRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301065900) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2018-02994) |
| 207Q00000X Family Medicine (Licence: NY 297055) | |
| 207Q00000X Family Medicine (Licence: AR E-11911) | |
| 207Q00000X Family Medicine (Licence: IN 01081567A) | |
| 207Q00000X Family Medicine (Licence: TX S0407) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2021-11-18 |