| NPI | 1205169521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GARRETT MCCULLEN Member 662-550-4299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2019-07-11 |