| NPI | 1619377454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL VANHOOSE Administrator 859-559-0804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: KY 36483) |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2015-09-16 |