| NPI | 1912653882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IBRAHIM FAHSAH Partner 502-386-6749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2022-03-01 |
| Last Update Date | 2022-09-01 |