| NPI | 1205939568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER M ROSE Director 502-451-9949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207LP3000X Anesthesiology, Pediatric Anesthesiology |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2015-11-24 |