| NPI | 1619202306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHA GUPTA Owner 502-295-8141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2009-10-14 |
| Last Update Date | 2011-09-29 |