NPI | 1366484263 |
---|---|
Entity Type | Organization |
Authorized Contact | BRIAN K. MONSMA Network Executive Director 712-279-2925 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 363AM0700X Physician Assistant Medical |
363L00000X Nurse Practitioner | |
363LF0000X Nurse Practitioner Family | |
Enumeration Date | 2006-06-12 |
Last Update Date | 2007-10-22 |