| NPI | 1194451567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA PODEIN Credentialing Systems Coordinator 231-830-2748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2022-07-28 |
| Last Update Date | 2022-07-28 |