| NPI | 1598138356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE FIFIELD Practice Administrator 315-361-2980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2015-11-02 |
| Last Update Date | 2015-11-02 |