| NPI | 1720090525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE H PETERS Md 502-366-0970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: KY 31716) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY 31716) |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 5222) | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2022-05-27 |