| NPI | 1568239770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE STRECKER Owner 502-566-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2023-12-07 |
| Last Update Date | 2023-12-07 |