| NPI | 1568905800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA ALEXANDER-COOK President 234-312-5873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2016-11-18 |
| Last Update Date | 2017-11-15 |