| NPI | 1508541392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERI ALEXANDER Chief Operating Officer 815-979-3495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2023-06-19 |
| Last Update Date | 2023-06-19 |