| NPI | 1578090403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHURSHEED AKRAM SIDDIQUI Medical Director 859-691-0201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 28741) |
| Additional Taxonomies | 261QR1300X Clinic/Center Rural Health |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2023-04-20 |