| NPI | 1386297711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANITA D JERGER Executive Assistant 855-538-9355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 163W00000X Registered Nurse |
| 208VP0000X Pain Medicine, Pain Medicine | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2020-08-24 |