NPI | 1659453439 |
---|---|
Former Name | LORI J O'BRIEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106376) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50-002502) |
Enumeration Date | 2006-10-20 |
Last Update Date | 2022-03-22 |