| NPI | 1013421353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT O MOGOI Sole Owner 316-519-1543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5377533) |
| Enumeration Date | 2017-11-22 |
| Last Update Date | 2017-11-22 |