| NPI | 1902135767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TED GROSBECK Manager 469-916-0521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Additional Taxonomies | 261QP3300X Clinic/Center Pain |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2016-06-06 |