| NPI | 1144429358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH BIVENS Office Manager 731-885-0787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2009-02-17 |