| NPI | 1891390548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAKALI R MICKELSON Office Manager 913-310-0482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0206X Pediatrics, Pediatric Gastroenterology |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine |
| 2080P0205X Pediatrics, Pediatric Endocrinology | |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2024-08-23 |