| NPI | 1952656167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OSVALDO ENRIQUE WAGENER President 708-609-0197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: IL 036086015) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2015-12-07 |