| NPI | 1598745283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA L HUGHES Practice Manager 502-897-5139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2019-11-27 |