| NPI | 1790447910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA PAYNE Authorised Official 304-989-0664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2021-10-06 |
| Last Update Date | 2021-10-06 |