| NPI | 1013884253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICK BRINEGAR Director 667-214-1301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery |
| Enumeration Date | 2025-10-22 |
| Last Update Date | 2025-10-22 |