| NPI | 1932720596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAJA MUPPAVARAPU Administrator 941-916-2313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2020-05-05 |