| NPI | 1689418436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTON BERTELSEN Project Manager 623-399-6880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology |
| Additional Taxonomies | 208800000X Urology |
| 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery | |
| Enumeration Date | 2024-06-25 |
| Last Update Date | 2024-06-25 |