| NPI | 1598634198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY WIMBERG VP Billing Operations 440-652-8748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2025-11-03 |
| Last Update Date | 2025-11-03 |