Individual
MRS. DIANE TREZA MOSCHOURIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6245 INKSTER RD, GARDEN CITY, MI 48135-4001
(734) 458-3300
Mailing address
29205 CANAL ST, NOVI, MI 48377-1985
(586) 554-4130
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704294241
MI
367500000X
Certified Registered Nurse Anesthetist
812962
NV
Other
Enumeration date
11/14/2018
Last updated
08/10/2020
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