| NPI | 1063758605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEN CHEYNE Physician 515-241-8198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: IA C-119097) |
| Enumeration Date | 2013-01-01 |
| Last Update Date | 2013-01-01 |