| NPI | 1366269029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY CLOUD Provider/Owner 308-252-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207ZP0102X Pathology Anatomic Pathology & Clinical Pathology | |
| Enumeration Date | 2024-09-24 |
| Last Update Date | 2024-09-24 |