| NPI | 1518121458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE ROMAN President 502-852-5241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2010-07-08 |