| NPI | 1952597577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YURIY SEREMBYTSKY Surgical Assistant 708-393-6431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 238.000044) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2007-09-18 |