| NPI | 1083851257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY KILLEEN Manager 502-368-9590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2017-11-10 |