| NPI | 1285190405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON BROCK Managing Partner 225-610-2051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2019-02-12 |