| NPI | 1073344651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THAD HOLLIST Managing Member 208-520-0035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2024-08-13 |
| Last Update Date | 2024-08-21 |