| NPI | 1245503515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL RICHARDSON NOBACK Medical Director 888-337-3309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Additional Taxonomies | 207L00000X Anesthesiology |
| Enumeration Date | 2012-02-17 |
| Last Update Date | 2012-07-30 |