| NPI | 1891879219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN P OLIPHANT Sole Member Owner 502-493-9994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: KY 30518) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2009-02-24 |