| NPI | 1649379447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH B. PETELIN Owner Of The Practice 913-432-5420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: KS 417417) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-08-22 |