| NPI | 1043520091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON ROSE BLASETTI Director Credentialing & Enrollment 770-945-5330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2010-10-08 |
| Last Update Date | 2011-02-17 |