| NPI | 1649781196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HILLARY FUAGATE Practice Manager 859-277-5711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 208200000X Plastic Surgery |
| 2086S0129X | |
| 2086X0206X Surgery, Surgical Oncology | |
| Enumeration Date | 2017-10-23 |
| Last Update Date | 2017-10-23 |