| NPI | 1336454313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNATHAN MILTON ISOM Managing Partner 901-797-9711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 20634) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MS R864279) |
| 163W00000X Registered Nurse (Licence: TN 82822) | |
| Enumeration Date | 2010-08-13 |
| Last Update Date | 2010-10-08 |