| NPI | 1174302194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE SANDERS Credentialing Manager 502-630-2036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology |
| Enumeration Date | 2023-09-28 |
| Last Update Date | 2023-09-28 |