| NPI | 1073353850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATRINA A MARSHALL Dir Pe, Credentialing And Licensing 919-648-1113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207K00000X Allergy & Immunology |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2024-05-29 |
| Last Update Date | 2024-05-29 |