| NPI | 1902076219 |
|---|---|
| Former Name | PAMELA JEANNE GRZESIKOWSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1710I1002X Military Health Care Provider, Independent Duty Corpsman |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2008-03-04 |