| NPI | 1992312862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MUHAMMAD MASROOR Director/Owner 502-500-8809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2020-09-25 |
| Last Update Date | 2024-06-11 |