RUSSELL EDAFETANURE-IBEH

CHICAGO, IL
NPI1568291268
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2024-07-31
Last Update Date2024-07-31
Business Address
RUSSELL EDAFETANURE-IBEH
1853 W POLK ST
CHICAGO, IL 60612-4355
Phone number: 312-996-5636
Mailing Address
RUSSELL EDAFETANURE-IBEH
1853 W POLK ST
CHICAGO, IL 60612-4355
Phone number:
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