| NPI | 1104615657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE DEE KASSMEIER Physician Assistant 402-660-2181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2025-05-01 |
| Last Update Date | 2025-08-29 |