| NPI | 1780198523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT C KANARD Owner 224-420-0879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0120X Surgery Pediatric Surgery |
| Additional Taxonomies | 208000000X Pediatrics |
| 2080P0203X Pediatrics Pediatric Critical Care Medicine | |
| Enumeration Date | 2017-11-30 |
| Last Update Date | 2017-11-30 |