| NPI | 1891730321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH FOURNET President 317-614-9863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2019-08-26 |