| NPI | 1831767011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIZ HUSSEY Credentialing Manager 833-749-8324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2021-06-15 |