| NPI | 1245350024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WORTLEY Executive Director 502-238-0801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |