| NPI | 1912541384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE P GREEN Owner 907-205-0332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2019-10-29 |
| Last Update Date | 2020-03-31 |