| NPI | 1053667600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY A RIEF Ownder 402-770-8027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 5122) |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2024-05-04 |