| NPI | 1679149322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL WHONSETLER Surgical First Assist 502-648-9210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2021-06-02 |