| NPI | 1679767610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE MCDERMOTT Office Manager 402-552-3015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2022-10-04 |