NPI | 1821042755 |
---|---|
Entity Type | Organization |
Authorized Contact | RICHARD HARRIS Authorized Representative 708-450-5055 |
Organization Subpart ? | No |
Primary Taxonomy | 208800000X Urology |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2006-05-22 |
Last Update Date | 2015-11-06 |