| NPI | 1255735346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN SMITH Practice Administrator 703-727-3462 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2024-01-08 |