| NPI | 1275611444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAPHENE R ROORDA Office Mnager 913-541-3377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 0418701) |
| 208600000X Surgery (Licence: KS 0418958) | |
| 2471S1302X Radiologic Technologist Sonography (Licence: 72262) | |
| 2471V0105X Radiologic Technologist Vascular Sonography (Licence: 72262) | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2020-12-10 |