| NPI | 1992872410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA M BETTENCOURT Practice Administrator 510-848-1733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2088P0231X Urology, Pediatric Urology |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2009-03-12 |