| NPI | 1003055914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANCE GREEN Owner 928-368-8118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AZ RN102790) |
| Enumeration Date | 2009-02-17 |
| Last Update Date | 2009-02-17 |