NPI | 1063617173 |
---|---|
Entity Type | Organization |
Authorized Contact | VELLAIAPPAN SOMASUNDARAM Owner 606-237-5800 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: KY 35436) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 35436) |
363LF0000X Nurse Practitioner Family (Licence: KY 3567P) | |
Enumeration Date | 2007-06-19 |
Last Update Date | 2010-04-29 |