| NPI | 1275547127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON BOOTS Practice Administrator 510-213-2261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2025-11-26 |