| NPI | 1003968686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR A MEDINA President 919-851-5055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2017-02-10 |