NPI | 1508645201 |
---|---|
Entity Type | Organization |
Authorized Contact | NASIRA MAH-JABEEN Credentialing Agent 502-579-0170 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Enumeration Date | 2023-09-22 |
Last Update Date | 2023-09-22 |