| NPI | 1457395493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH W SANDERS Md 318-841-4486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: LA 017152) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2020-03-06 |