| NPI | 1912597808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE VAUGHAN Practice Manager 404-419-0237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2021-01-25 |
| Last Update Date | 2022-02-23 |