Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath |
NPI | 1699130435 |
---|---|
Provider Name | Mrs. Pamela Williams |
First Address | Jacksonville, FL 32209-3255 |
Second Address | Jacksonville, FL 32209-3255 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2015 |
Last Update Date | 21/12/2015 |