| NPI | 1982236956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RELANDA PRICE Lead Enrollment COO Rdinator 517-884-2976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 2088F0040X Urology Female Pelvic Medicine and Reconstructive Surgery |
| 2088P0231X Urology Pediatric Urology | |
| 208C00000X Colon & Rectal Surgery | |
| Enumeration Date | 2020-02-07 |
| Last Update Date | 2023-01-23 |