| NPI | 1881245314 |
|---|---|
| Other Name | MKBB LLC |
| Entity Type | Organization |
| Authorized Contact | MARIA KORDAS Director 224-713-0003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2021-04-19 |