| NPI | 1558987883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMIR H NAVIK Auhtorized Representative 217-553-8966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2020-06-26 |