| NPI | 1972050235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILFRED MARCO VICTORINA President 859-496-1803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: FL ME126126) |
| Enumeration Date | 2016-09-04 |
| Last Update Date | 2017-04-06 |