| NPI | 1104132687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAMLESH C DAVE Owner/Presidnet 502-693-2465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363LF0000X Nurse Practitioner, Family | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2010-08-23 |
| Last Update Date | 2011-08-26 |