| NPI | 1902638588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANGELA ROBERSON Owner 708-439-0652 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2024-08-14 |
| Last Update Date | 2024-08-14 |