| NPI | 1477512408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY R MATHENY Treasurer 304-422-3904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2021-11-02 |