| NPI | 1942802111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMAL OTULA Registered Agent 972-310-7121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| 207L00000X Anesthesiology | |
| Enumeration Date | 2020-11-12 |
| Last Update Date | 2020-11-12 |