| NPI | 1003273517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA FOX Credentialing Specialist 336-553-3999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2016-01-28 |