| NPI | 1043764814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN SMITH Owner 843-504-7194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| 367H00000X Anesthesiologist Assistant | |
| Enumeration Date | 2016-08-10 |
| Last Update Date | 2016-08-29 |