| NPI | 1083915151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYNA L. FRIEND CFO 317-776-7228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IN 10001233A) |
| Enumeration Date | 2010-11-05 |
| Last Update Date | 2023-08-01 |