| NPI | 1760934889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY KONDAS Officer 317-614-9871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2021-04-20 |