| NPI | 1629849179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NASIRA MAH-JABEEN Director Of Operations 502-579-0170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2024-01-12 |
| Last Update Date | 2024-11-04 |