NPI | 1447669478 |
---|---|
Entity Type | Organization |
Authorized Contact | STACY L RALSTON Practice Administrator 502-368-9561 |
Organization Subpart ? | No |
Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: KY 3008801) |
Enumeration Date | 2014-08-04 |
Last Update Date | 2014-08-04 |