| NPI | 1023105905 |
|---|---|
| Doing Business As | CRNA |
| Entity Type | Organization |
| Authorized Contact | MARK NANTZ Chief Administrative Officer 704-783-1176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2007-09-18 |