| NPI | 1215067780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES B SHANE Owner Physician 502-895-7445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: KY 18903) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2009-02-24 |