| NPI | 1124649389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES BEAULIEU President 480-213-8451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2021-06-25 |