| NPI | 1871537464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON CONANT Practice Administrator 716-836-7510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2018-06-21 |