| NPI | 1740623057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIE L. BUTTS Credentialing Supervisor 402-504-4680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NE 25671) |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2015-10-21 |