| NPI | 1629090642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN J. NEWMAN Director Of Accounting 815-877-4848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2016-01-20 |