| NPI | 1215281761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ABRAHAM Incorporator/Shareholder 417-619-1329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO MD115778) |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2012-11-06 |