| NPI | 1154568632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER W SPENCER Member 941-360-1566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2009-01-20 |
| Last Update Date | 2009-01-20 |