| NPI | 1457458820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE BREWER Director Of Provider Enrollment 877-892-9813 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| 207R00000X Internal Medicine | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2008-02-08 |