| NPI | 1578916482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMALA LEA WILSON Managing Member 918-704-5556 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: CO 0991841) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2016-07-14 |