| NPI | 1770066292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOLLY A ROBERSON Physician Assistant/Owner 502-489-4325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-09-11 |
| Last Update Date | 2018-11-05 |