| NPI | 1902465560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESLEY A DICKSON Authorized Official 888-709-3117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2021-03-16 |