| NPI | 1255293437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA KEITEL Office Manager 866-333-0570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2025-11-26 |
| Last Update Date | 2025-11-26 |