| NPI | 1760767529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMAD ABID MALIK Owner 816-809-6850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2011-10-12 |