| NPI | 1649547068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK STEPHEN MOORE Owner/Pres. 770-536-8109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2012-04-18 |