| NPI | 1942671805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD DOUBERLY Member Manager 912-704-0414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2015-10-16 |
| Last Update Date | 2022-08-18 |