| NPI | 1033675079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHALA DAVIS Rcs Manager 704-303-7517 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0402X Psychiatry & Neurology Neurology with Special Qualifications in Child Neurology |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2021-08-16 |