| NPI | 1316394927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN F MARTINDALE Owner 502-819-5593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IN 28143085A) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: IN 28143085A) |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2016-05-24 |