| NPI | 1881041515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNNE IMHOFF Sole Member 918-728-4504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OK 13167) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2016-05-23 |