| NPI | 1154792505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN EUGENE FARRRELL Owner 816-931-5594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MO 113250) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2008021948) |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2021-02-19 |