| NPI | 1699410548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH MENTZER Owner 859-447-8014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics |
| Enumeration Date | 2022-05-04 |
| Last Update Date | 2022-08-02 |