NPI | 1275728289 |
---|---|
Entity Type | Organization |
Authorized Contact | MENGISTU YEMANE Dr/ President 606-451-8644 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 38234) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 4821P) |
Enumeration Date | 2007-09-12 |
Last Update Date | 2010-12-01 |