| NPI | 1629635818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OWEN BAILEY Chief Operating Officer 251-471-7110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2019-05-22 |