| NPI | 1215315692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSS RONAN Vice President 469-401-2386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2015-05-18 |