LISA LICAVOLI

ROYAL OAK, MI
NPI1558339960
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: MI  4704189302)
Enumeration Date2006-03-10
Last Update Date2012-12-04
Business Address
-- LISA LICAVOLI CRNA
3601 W 31 MILE RD 400 FSC - PCS
ROYAL OAK, MI 48073-6769
Phone number: 248-423-3144
Mailing Address
-- LISA LICAVOLI CRNA
3601 W 31 MILE RD 400 FSC - PCS
ROYAL OAK, MI 48073-6769
Phone number: 248-423-3144
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