Individual
OMOTARA KUFEJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-7075
Mailing address
25002 RIEMA ST, TAYLOR, MI 48180-7975
(313) 244-4161
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704287651
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704287651
MI
Other
Enumeration date
09/10/2018
Last updated
02/07/2019
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