NPI | 1114362456 |
---|---|
Entity Type | Organization |
Authorized Contact | AKAVUT SUESAKUL Owner 312-532-7472 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
Enumeration Date | 2013-04-30 |
Last Update Date | 2013-10-15 |