| NPI | 1215433974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAHMOUD SAMMAN Director/Owner 502-533-3919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2021-08-23 |