| NPI | 1578686762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIRAJ U SIDDIQI Owner 502-225-9098 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 28062) |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2018-01-23 |