| NPI | 1003040502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD DOUBERLY Authorized Official 941-360-1566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2022-06-06 |