| NPI | 1104841063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KOSIT PRIEB President 618-233-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: IL 042-005690) |
| Additional Taxonomies | 2086S0105X Surgery, Surgery of the Hand (Licence: IL 042-005690) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2010-07-12 |