| NPI | 1508390519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN PETERSEN Owner/Provider 214-244-1756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2017-04-17 |