| NPI | 1477646446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY JAMES WALTER President 502-456-3990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: 215554) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: 17516) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2010-03-12 |