| NPI | 1891390548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAKALI R MICKELSON Office Manager 913-310-0482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0205X Pediatrics, Pediatric Endocrinology |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine | |
| 2080P0206X Pediatrics, Pediatric Gastroenterology | |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2023-07-11 |