| NPI | 1093595969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA KYMBERLIE SPARKS RAMOS Owner And Physician Associate 919-704-7324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Enumeration Date | 2023-09-29 |
| Last Update Date | 2025-10-29 |