| NPI | 1124594189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH DANIELS Owner/Authorized Official 765-284-0493 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2018-10-17 |
| Last Update Date | 2018-10-17 |