| NPI | 1710102629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK O GLADSTEIN Physician 502-589-4448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2009-12-23 |