| NPI | 1093005878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES ANTHONY TUDOR Managing Partner 704-663-4989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NC 101593) |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2014-04-01 |