| NPI | 1063044881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUNG Q PHAM Owner 346-339-5949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 2088P0231X Urology, Pediatric Urology |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2022-04-11 |