| NPI | 1902223787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY ANN MCCLURE Owner 620-218-1623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: KS 04-31220) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: KS 04-31220) |
| Enumeration Date | 2014-03-18 |
| Last Update Date | 2014-10-08 |