| NPI | 1629461751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYED R QUADRI Memeber 270-723-4772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 34388) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2015-03-13 |
| Last Update Date | 2018-06-11 |