| NPI | 1174085203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANJAY JAIN Tin Owner 502-365-5137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2019-04-06 |
| Last Update Date | 2019-04-06 |