| NPI | 1750514378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TATIYANA M URBIN Presedent 224-659-1658 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: IL 038009006) |
| Enumeration Date | 2009-08-30 |
| Last Update Date | 2009-08-30 |