| NPI | 1215411327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA BOSTON Physician 913-368-3760 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2023-04-23 |