| NPI | 1043512783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM ANTHONY GORE Managing Member 910-465-2783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 101955) |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2010-12-01 |