| NPI | 1174353734 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR E OTANO-RIVERA Urologist (CEO) 267-624-3578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2024-08-07 |
| Last Update Date | 2024-10-23 |