| NPI | 1982105425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAINA PATERA Practice Manager 402-505-8777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NE 28493) |
| Additional Taxonomies | 174400000X Specialist |
| 207N00000X Dermatology | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2018-02-21 |
| Last Update Date | 2023-01-20 |