| NPI | 1336025048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS MCKENZIE LUSTEK Certified Registered Nurse Anesthet 262-305-8211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2025-08-15 |
| Last Update Date | 2025-08-15 |