| NPI | 1265743280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY C. WILT Owner/Member 843-492-5679 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2010-06-24 |