| NPI | 1689960239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEMMA ARBUES CIESEMIER President 660-988-5770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2002021764) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2011-09-16 |