| NPI | 1679047955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE LUIS NUNO Owner 402-315-7538 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2019-01-19 |
| Last Update Date | 2019-04-05 |