| NPI | 1558645382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE PAUL WIDMAN Owner 402-613-2163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NE 19209) |
| Enumeration Date | 2011-09-28 |
| Last Update Date | 2011-09-28 |