| NPI | 1114669538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | POPPY WALKER Practice Administrator 325-660-5535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2022-04-07 |
| Last Update Date | 2022-07-04 |