| NPI | 1902379928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAJAEE BLACK Owner 215-500-7580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Additional Taxonomies | 207L00000X Anesthesiology |
| Enumeration Date | 2019-01-03 |
| Last Update Date | 2019-01-03 |