| NPI | 1790140556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM WHITCOMB Administrator 402-578-2512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208D00000X General Practice | |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2016-01-06 |