| NPI | 1063988228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHURSHEED A SIDDIQUI Owner 859-236-0606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine |
| 207QA0401X Family Medicine, Addiction Medicine | |
| 207RA0401X Internal Medicine, Addiction Medicine | |
| Enumeration Date | 2018-10-15 |
| Last Update Date | 2018-10-24 |