| NPI | 1912054792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAWAR SODA Partner 859-985-0302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2016-05-12 |