| NPI | 1053021303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW STIVERS President 502-352-8896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-11-28 |
| Last Update Date | 2022-12-12 |