| NPI | 1871128447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN NEJMAN Credentialing Specialist 814-868-2507 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 2086S0129X |
| 208800000X Urology | |
| Enumeration Date | 2020-03-04 |
| Last Update Date | 2025-06-13 |