| NPI | 1730161753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA LYNN ROOS Billing Office Manager 502-587-9660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2021-08-16 |