| NPI | 1841482577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATAKOM NASH CHULAMORKODT President 773-501-7706 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: AZ 37017) |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2020-08-12 |