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 |