| NPI | 1003479403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH H NICKERSON President 714-658-0091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2019-04-22 |