| NPI | 1972951275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEOPHILE KOURY Authorized Offical 800-516-5315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2016-05-26 |