| NPI | 1245738863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY GAST VP Managed Care 502-588-9490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery Hand Surgery |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| 207X00000X Orthopaedic Surgery | |
| 2086S0105X Surgery Surgery of the Hand | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2018-01-29 |
| Last Update Date | 2021-09-21 |