| NPI | 1598873762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA SCHROEDER Business Manager 402-467-4361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery |
| 207NS0135X Dermatology Procedural Dermatology | |
| 363AM0700X Physician Assistant Medical | |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2010-07-02 |