| NPI | 1396002473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA R SANDEFUR Practice Administrator 859-260-7700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2019-07-25 |