| NPI | 1609836535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK L SHERIDAN Administrator 308-384-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NE 22426) |
| Additional Taxonomies | 174400000X Specialist (Licence: NE 22426) |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2022-07-21 |