| NPI | 1740255793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMMIE LEE MCKIBBAN Owner Member Of LLC 316-321-3300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2020-08-22 |