| NPI | 1750067666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD GERALD HARRIS CEO 708-450-5055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2023-06-26 |