| NPI | 1023837101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP KIM Owner 267-679-1272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2024-10-07 |
| Last Update Date | 2024-10-07 |