| NPI | 1942562467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | POMILLA KUMAR Owner 563-332-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2012-06-11 |