| NPI | 1861549131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID PAIGE LEIBEL Owner Officer 503-325-7888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 2088P0231X Urology, Pediatric Urology |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2020-08-22 |