| NPI | 1912978610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY PETROSS Client Liaison 817-334-0530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2021-05-25 |