| NPI | 1811420607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED DERANEY Member Manager 888-510-1352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2017-04-07 |