| NPI | 1992211148 |
|---|---|
| Former Name | PAMELA JEAN WESTENDORF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IA 073758) |
| Enumeration Date | 2017-12-26 |
| Last Update Date | 2017-12-26 |