| NPI | 1407610702 |
|---|---|
| Other Name | PRIMARY CARE CLINIC |
| Entity Type | Organization |
| Authorized Contact | DEV SUBEDI CEO 502-855-0193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2024-02-08 |
| Last Update Date | 2024-02-08 |