| NPI | 1821758830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHALED MANASRAH Manager 224-288-8847 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2021-12-19 |
| Last Update Date | 2021-12-19 |