| NPI | 1417658956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER ERIC BROWN Owner 270-982-0826 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2023-03-13 |
| Last Update Date | 2024-02-05 |