| NPI | 1700151818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA L PETERSON General Pediatrician/Manager 816-525-2800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: MO 2008015364) |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2016-04-26 |