| NPI | 1346645140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANNINE DERANEY Administrator 678-592-6633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2014-10-23 |