| NPI | 1972225571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER BYERS Payer Enrollment Specialist 231-876-7807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| 367H00000X Anesthesiologist Assistant | |
| Enumeration Date | 2022-09-12 |
| Last Update Date | 2023-08-07 |