| NPI | 1386193134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANAND GUPTA Member 502-893-7133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: KY 33458) |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2023-10-30 |