| NPI | 1942879580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL S BREWTON Owner 936-552-4760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2021-06-18 |
| Last Update Date | 2021-08-10 |