| NPI | 1093105306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY LAMB VP/Contracting 502-588-4210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics Pediatric Hematology-Oncology |
| Additional Taxonomies | 2080P0205X Pediatrics Pediatric Endocrinology |
| 2080P0206X Pediatrics Pediatric Gastroenterology | |
| 2080P0214X Pediatrics Pediatric Pulmonology | |
| 363L00000X Nurse Practitioner | |
| 363LP0200X Nurse Practitioner Pediatrics | |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2015-01-26 |