| NPI | 1104604198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | POPPY WALKER Practice Administrator 325-675-6466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2023-09-20 |
| Last Update Date | 2023-09-20 |