| NPI | 1124063078 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GUSHO CFO, Treasurer 734-398-0642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2023-01-30 |