| NPI | 1043052632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN MELISSA TIBEDO National Pe Director 865-985-7130 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2024-06-12 |
| Last Update Date | 2024-06-12 |