| NPI | 1841562733 |
|---|---|
| Former Name | PAMELA SUZANNE JACKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 21608) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 766010) |
| Enumeration Date | 2012-02-07 |
| Last Update Date | 2012-02-07 |