| NPI | 1083809669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY HENSON Rcd 336-944-6420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 2085N0904X Radiology Nuclear Radiology | |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2023-01-13 |