| NPI | 1407242241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISHA YAGHMAI President 800-924-8140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-33447) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 04-33447) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2018-02-23 |