| NPI | 1083101240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAWAR SODA Owner 859-523-5310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center Urgent Care |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2018-07-31 |