| NPI | 1740674050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN TAIMOORAZY Authorized Official 224-231-4363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2015-03-25 |