| NPI | 1558415760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC J SIEGEL Medical Doctor 502-633-7337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 28387) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY PA557) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3006166) | |
| 163W00000X Registered Nurse (Licence: KY 1121406) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3007777) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2013-03-27 |