| NPI | 1780139287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID O DICK Authorized Representative 757-288-9149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2016-08-25 |