| NPI | 1043818156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSHINDA MILES Director 803-543-8559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2024-02-06 |