NPI | 1508171612 |
---|---|
Entity Type | Organization |
Authorized Contact | MATTHEW M GLENN Owner 402-421-2100 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 363L00000X Nurse Practitioner |
Enumeration Date | 2010-08-12 |
Last Update Date | 2012-05-22 |