| NPI | 1235675364 |
|---|---|
| Doing Business As | PEDIATRIC UROLOGY ASSOCIATES - IDAHO |
| Entity Type | Organization |
| Authorized Contact | SAMUEL FINLAYSON Chief Clinical Officer 801-587-6336 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology |
| Enumeration Date | 2017-01-12 |
| Last Update Date | 2022-04-13 |