| NPI | 1295817799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON HAFRON Chief Medical Officer 586-771-4820 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 208800000X Urology |
| 2088P0231X Urology, Pediatric Urology | |
| 332900000X Non-Pharmacy Dispensing Site | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2024-08-20 |