| NPI | 1215654553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORETTA ANN BOSTIC Managing Member 304-208-0707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2022-10-27 |
| Last Update Date | 2022-11-07 |