| NPI | 1205090347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA JONES Credentialing 773-844-5921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 202K00000X |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery |
| 2085R0204X Radiology, Vascular & Interventional Radiology | |
| 208600000X Surgery | |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2022-12-31 |