| NPI | 1477247807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL ANNETTE WATHEN Secretary Treasurer 812-450-3296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 208VP0000X |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2023-06-07 |
| Last Update Date | 2025-01-13 |