| NPI | 1154980753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANITA D JERGER Executive Assistant 855-538-9355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 163W00000X Registered Nurse |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2020-08-24 |