| NPI | 1043555204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT CLEMENS CEO 660-826-5960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2012-11-29 |
| Last Update Date | 2020-02-21 |