| NPI | 1285042028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDOLPH SITES Executive Director 901-545-7125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2017-10-30 |