| NPI | 1306187612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD ELDON PARK President 859-341-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2013-03-12 |