Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 4704309385 | MI |
NPI | 1053948190 |
---|---|
Provider Name | Cassi Osak |
First Address | Clinton Township, MI 48036-4051 |
Second Address | Clinton Township, MI 48036-4051 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2020 |
Last Update Date | 26/03/2020 |