| NPI | 1124253810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAINE GAY FUKUDA Member 808-521-8288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: HI 15080) |
| Additional Taxonomies | 208800000X Urology (Licence: HI MD-15080) |
| Enumeration Date | 2009-05-25 |
| Last Update Date | 2010-09-20 |