| NPI | 1013662766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA ANN RENTERIA Manager 346-633-8153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine |
| 363LC0200X Nurse Practitioner, Critical Care Medicine | |
| Enumeration Date | 2022-02-21 |
| Last Update Date | 2023-08-23 |