| NPI | 1225198294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN MARIE CARTER Medical Billing 502-647-5468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine (Licence: KY 29789 AND 29596) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-08-22 |