| NPI | 1013973296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB K. LUDER President 417-239-3392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2016-06-01 |