| NPI | 1225226053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE S. HOLDEN Office Nurse/Manager 913-499-6901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: KS 04-17546) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MO R6677) |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2023-09-06 |