| NPI | 1780334466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY RENE' RICHARD Owner / Provider 307-532-3035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2022-03-25 |
| Last Update Date | 2022-03-25 |