NPI | 1134212665 |
---|---|
Entity Type | Organization |
Authorized Contact | TAPAN ASHVIN MEHTA Owner 815-933-4510 |
Organization Subpart ? | No |
Primary Taxonomy | 173000000X Legal Medicine (Licence: IL 036097467) |
Additional Taxonomies | 173000000X Legal Medicine (Licence: IL 036110330) |
Enumeration Date | 2006-10-02 |
Last Update Date | 2020-08-22 |