| NPI | 1750500526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA JEAN EDWARDS Practice Manager 616-808-3944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2020-08-22 |