| NPI | 1003086158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DION DEBRO CHAVIS Owner 317-844-7706 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IN 01042615) |
| Additional Taxonomies | 2086S0105X Surgery, Surgery of the Hand (Licence: IN 01042615) |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2012-03-07 |