Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist |
NPI | 1902832512 |
---|---|
Provider Name | Dr. Pamela Marie Kimball |
First Address | Richmond, VA 23219-1441 |
Second Address | Richmond, VA 23219-1441 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2006 |
Last Update Date | 04/10/2011 |