| NPI | 1689617953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARK P. CHRISTIANSON President 251-633-1660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2013-01-31 |