| NPI | 1982620050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRZYBOWSKI JOHN Secretary Of Organization 502-301-7408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2020-08-22 |