NPI | 1568750420 |
---|---|
Entity Type | Organization |
Authorized Contact | KELLI L BOWMAN Office Manager 816-637-0117 |
Organization Subpart ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MO R6H00) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2011006205) |
Enumeration Date | 2011-07-13 |
Last Update Date | 2011-07-13 |