| NPI | 1679768899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY DEROUCHEY Practice Manager 402-330-0444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NE 16148) |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2008-08-07 |