| NPI | 1790277135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWAYNE COX Authorized Representative 323-717-9436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2018-06-19 |