| NPI | 1669700571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN JOSEPH GANCARCZYK President 918-749-8765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 246Z00000X Specialist/Technologist, Other (Licence: OK 117717) |
| Enumeration Date | 2009-12-04 |
| Last Update Date | 2022-04-05 |