| NPI | 1013146612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA DIANE POWELL Manager 704-995-7941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2009-07-06 |