| NPI | 1255492682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA L FREEMAN Office Manager 270-442-8228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2011-06-15 |