| NPI | 1790038883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LEE NICOLAS Administrator 818-565-9802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207L00000X Anesthesiology |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2016-08-11 |