| NPI | 1417974494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THONGCHAI VACHIRASOMBOON President 219-757-6077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2020-08-22 |