| NPI | 1801859319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE BREWER Provider Enrollment Director 877-892-9813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| 207L00000X Anesthesiology | |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2008-03-11 |