NPI | 1538250832 |
---|---|
Entity Type | Organization |
Authorized Contact | GUS A BYNUM President 502-868-0008 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 363L00000X Nurse Practitioner |
Enumeration Date | 2006-09-28 |
Last Update Date | 2008-05-14 |