| NPI | 1487012761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RASHIDA RANDEREE Owner 302-245-6094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: IL 036.118933) |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2016-02-02 |