| NPI | 1346569142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEAN ROGER LOSS President 706-868-1410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: GA RN108812) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: SC 1388) |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2011-04-13 |