| NPI | 1245744515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KESHAWN GARDNER Surgical Assistant 708-215-1604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2017-11-25 |
| Last Update Date | 2018-07-10 |