| NPI | 1427404037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHURSHEED A SIDDIQUI Owner 859-691-0201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LA0401X Anesthesiology Addiction Medicine |
| Additional Taxonomies | 207QA0401X Family Medicine Addiction Medicine |
| 207RA0401X Internal Medicine Addiction Medicine | |
| 2084A0401X Psychiatry & Neurology Addiction Medicine | |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2020-02-27 |