| NPI | 1710211941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH SINCLAIR Owner 606-305-8022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: KY 28427) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine (Licence: KY 28427) | |
| 208600000X Surgery | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2015-12-14 |