| NPI | 1871659466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN FREDERICK SAMUEL President 502-583-7741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2022-07-26 |