| NPI | 1548757859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FADI BACHA Owner 859-312-9674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2021-04-06 |