| NPI | 1306843305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA LEE DESVERREAUX Billing Contact 251-965-5393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2009-04-07 |