| NPI | 1780115998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISHA HAQ Md 502-969-2227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 33462) |
| 208000000X Pediatrics (Licence: KY 32576) | |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2019-11-21 |