| NPI | 1366795221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN KNUEVEN Supervisor 567-585-1969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2023-10-12 |