NPI | 1205021102 |
---|---|
Entity Type | Organization |
Authorized Contact | SUE K STROMER Credentialer 402-462-5109 |
Organization Subpart ? | No |
Primary Taxonomy | 208800000X Urology (Licence: KS 0423520) |
Additional Taxonomies | 208800000X Urology (Licence: KS 0420442) |
363AM0700X Physician Assistant, Medical (Licence: KS 1500834) | |
Enumeration Date | 2007-09-13 |
Last Update Date | 2008-09-05 |