| NPI | 1700831708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA G DYCUS Office Manager 270-441-4125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2020-08-22 |