| NPI | 1215688528 |
|---|---|
| Former Legal Business Name | NONE |
| Entity Type | Organization |
| Authorized Contact | MUHAMMAD USMAN Partner 848-468-7778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service |
| Enumeration Date | 2022-01-18 |
| Last Update Date | 2022-01-18 |