| NPI | 1407696289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISON BLAKE SWIBEL Sole Member 847-494-2256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2024-05-29 |
| Last Update Date | 2024-05-29 |