| NPI | 1386740025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLEMON PARDALES President 248-366-9504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2020-08-22 |