| NPI | 1194223313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDRA DIONNE SHEPPARD President 502-599-3245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AL 28922) |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2018-03-17 |