| NPI | 1275639908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENI R BENNETT Credentialing Manager 937-435-6136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: OH 35-086518) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2008-06-20 |