| NPI | 1164754958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN MINTER Practice Administrator 502-452-9567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2010-02-04 |
| Last Update Date | 2023-09-07 |