| NPI | 1194960682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS S. GRAY Owner 502-456-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2020-06-10 |