| NPI | 1629054994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR E. GRIGORIEV Mng Mbr 702-233-0727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 2085R0001X Radiology, Radiation Oncology | |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2023-07-04 |