| NPI | 1437203098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUETTA CODY Manager, Provider Enrollment 404-785-7876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| 367H00000X Anesthesiologist Assistant | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2023-03-28 |