| NPI | 1033179700 |
|---|---|
| Former Name | CYNTHIA M THEOBALD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 7814) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50-002328) |
| Enumeration Date | 2006-03-25 |
| Last Update Date | 2022-06-29 |