| NPI | 1134573090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA MELLEN Owner 800-821-6993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2018-04-26 |