| NPI | 1508550088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH DAVIS Director Of Revenue 859-533-1109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology |
| Additional Taxonomies | 207L00000X Anesthesiology |
| Enumeration Date | 2023-06-07 |
| Last Update Date | 2023-11-10 |