| NPI | 1053038471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN LYNN RODGERS Credentialing Supervisor 401-659-5589 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2022-10-26 |
| Last Update Date | 2024-03-26 |