| NPI | 1043620347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONJA D THOMPSON Practice Administrator 336-538-1966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: NC 9700217) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: NC 9700217) |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2014-07-23 |