| NPI | 1194536243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN NOEL LARROZA CEO 773-946-6068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2025-01-17 |
| Last Update Date | 2025-03-10 |