| NPI | 1447641618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE K LEE Physician Assistant 712-256-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IA 076997) |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2015-02-16 |