| NPI | 1235181223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGG L BRENT President 810-606-6499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2014-04-22 |