Individual
JACOB HUMENIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
5900 N LOTZ RD, CANTON, MI 48187-4331
(734) 394-4500
Mailing address
5900 N LOTZ RD, CANTON, MI 48187-4331
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704343272
MI
Other
Enumeration date
12/09/2022
Last updated
12/09/2022
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