| NPI | 1740602424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH PATRICK NICOLLERAT Owner 919-280-6612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2014-01-14 |
| Last Update Date | 2014-01-14 |