| NPI | 1942314661 |
|---|---|
| Former Name | PAMELA LYNN TRACY/DIZNEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL ARNP1027292) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2007-07-08 |