| NPI | 1386214757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN L BENNETT Sole Member 423-899-9080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2021-09-08 |