| NPI | 1891932448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH DAVID STANLEY Managing Member 706-207-5407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2009-01-18 |
| Last Update Date | 2009-01-18 |