| NPI | 1871533398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES L YATES Authorized Representative 270-762-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2007-09-20 |