| NPI | 1124071055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY GOSSETT Authorized Representative 205-939-7143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2020-08-22 |