| NPI | 1225718265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KORY TODD JOHNSON Owner Of Entity 361-548-1610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2023-07-24 |