Individual
VALBONA ILIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
794 CADIEUX RD, GROSSE POINTE, MI 48230-1232
(313) 355-6550
Mailing address
794 CADIEUX RD, GROSSE POINTE, MI 48230-1232
(313) 355-6550
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704281187
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
701252
MI
367500000X
Certified Registered Nurse Anesthetist
AP129829
TX
Other
Enumeration date
09/03/2015
Last updated
04/20/2016
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