| NPI | 1902094485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER THOMAS GRUBB Manager, Direct Owner 888-418-0333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2002-01468) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2002-01468) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2008-01-16 |