| NPI | 1881702058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES STANLEY DAVIS President Of Corp 757-499-4932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: VA 0101018138) |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2008-02-20 |