| NPI | 1750302832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIROUS NOURBAKHSH Physician Assistant 785-350-3111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-00217) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2020-08-22 |