| NPI | 1679777908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODNEY JAMES MALISOS President 816-415-2233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2000146367) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2013-09-10 |