| NPI | 1073935250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY TRYON Supervisor 209-956-7732 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2014-01-07 |
| Last Update Date | 2025-10-28 |