| NPI | 1578636254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS A RUSSELL President 402-991-0137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2013-08-16 |