| NPI | 1518929157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIZ WILDEN Administrator 573-445-7300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2011-01-26 |