| NPI | 1215930425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE FASSNACHT Practice Administrator 330-344-6401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2018-04-12 |