NPI | 1720370133 |
---|---|
Entity Type | Organization |
Authorized Contact | LORNELL EUGENE HANSEN President 605-275-6128 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 4768) |
Additional Taxonomies | 202K00000X Phlebology |
Enumeration Date | 2011-05-04 |
Last Update Date | 2019-11-22 |