| NPI | 1265487359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS SANDOVAL Office Manager 620-408-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2012-02-15 |