| NPI | 1801389267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN RAWERT Manager, Payor Enrollment 816-502-8782 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2020-11-30 |