| NPI | 1598401374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARJON MONFARED Owner 816-518-2371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2022-05-05 |
| Last Update Date | 2022-05-05 |