| NPI | 1154331387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD G SHASHY Owner 502-867-7806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2019-10-08 |