| NPI | 1104358464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM BERRY Chief Executive Officer 651-968-5333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2017-04-20 |