| NPI | 1801831268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL MASON GUSTAFSON Administrator 402-441-4760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207RB0002X Internal Medicine, Bariatric Medicine |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2019-02-12 |