| NPI | 1538419148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HILLEL PELTZ Owner/Physician/CEO 417-353-9069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NJ 25MB07628300) |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2024-03-01 |