| NPI | 1740426485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY SIMPSON Provider Enrollment Manager 720-381-2805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2008-12-31 |
| Last Update Date | 2024-03-05 |