NPI | 1851341440 |
---|---|
Entity Type | Organization |
Authorized Contact | MELISSA ANN RUSSO Vice President 816-508-4082 |
Organization Subpart ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
Additional Taxonomies | 207R00000X Internal Medicine |
363L00000X Nurse Practitioner | |
Enumeration Date | 2006-05-12 |
Last Update Date | 2025-07-02 |