| NPI | 1932122769 |
|---|---|
| Former Name | PAMELA KAY DELOACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation Sports Medicine (Licence: MS 61OT030) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2011-11-18 |