| NPI | 1093250904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JOHN DUMOND Chief Operating Officer 704-607-3483 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 200200214) |
| Enumeration Date | 2017-01-01 |
| Last Update Date | 2017-01-01 |