| NPI | 1558479287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE G VILLANUEVA Physician 502-891-8981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: KY 31793) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2020-08-22 |