| NPI | 1013966506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKKI KILLIAN Business Office Coordinator 231-935-5770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2007-11-02 |