| NPI | 1932567021 |
|---|---|
| Former Name | PAMELA GRANTHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 3056592) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN306592) |
| Enumeration Date | 2016-02-03 |
| Last Update Date | 2022-11-08 |