| NPI | 1548439110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISTY GUNTER RUSSIAN Supervisor, Provider Enrollment 517-253-6308 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 230020) |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2024-03-18 |