| NPI | 1205189446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET ANN GROLL Business Office Manager 502-561-0520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: KY 35219) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 35219) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 35219) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: KY 35219) | |
| 363L00000X Nurse Practitioner | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2024-01-31 |