| NPI | 1073772612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MICHAEL NULTY President 336-324-3116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Additional Taxonomies | 207L00000X Anesthesiology |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2021-12-10 |