| NPI | 1639182389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITTA A. REDDY Owner 270-651-8338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2014-01-22 |