| NPI | 1184098212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODI L HENRIKSON Physician 620-792-2151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KS 04-30709) |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2015-12-01 |