| NPI | 1174655880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA HASTETTER Practice Manager 812-476-6161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: IN 01062143A) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2007-10-16 |