| NPI | 1982360483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMEGA SAVAGE Owner/Provider 502-821-0652 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2021-11-10 |
| Last Update Date | 2021-11-10 |