| NPI | 1801529854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN KOSTELNIK Physician Owner 859-229-5198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2022-07-07 |
| Last Update Date | 2022-09-03 |