| NPI | 1265861793 |
|---|---|
| Former Name | BROOKE REBA PAUL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.003817RX) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: OH 50.003817RX) |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2018-10-04 |