| NPI | 1457742587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY N SPENCER Physician Assistant 712-256-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IA 076849) |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2015-02-16 |