| NPI | 1386019503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUN WHITE Credentialing Manager 502-244-9859 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 230907) |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2022-07-18 |