| NPI | 1629365754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT KAIL Manager 417-234-3868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2000164718) |
| Enumeration Date | 2011-07-10 |
| Last Update Date | 2011-10-20 |