| NPI | 1043482094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAUREEN E MAHONEY Credentialing Specialist 402-391-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2023-09-12 |