| NPI | 1376619320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID PAUL HARRIES Member 859-264-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: KY 37745) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: KY 0783) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2007-12-24 |