| NPI | 1417389396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID VAN DAM Owner 248-421-5876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: MI 4704115131) |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2013-11-11 |