| NPI | 1124184510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKY L KRAUSE Clinic Manager 605-718-7450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SD 1584) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SD 0348) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2008-04-20 |