| NPI | 1073952107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENETHA D MORAN Officer/Authorized Official 972-763-3893 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2013-06-21 |