| NPI | 1538298872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUPACHAI SUWATANAPONGCHED President 708-596-2445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: IL 036045385) |
| Enumeration Date | 2007-03-04 |
| Last Update Date | 2020-08-22 |