| NPI | 1053454256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAKASHA L STEWART-HUBBARD Owner 502-386-3875 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 041071) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2007-07-11 |