| NPI | 1780838847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAWAR SODA Owner 859-466-8956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2008-11-15 |
| Last Update Date | 2016-05-12 |