| NPI | 1124353164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAUL CESAR AIZCORBE Owner President 704-825-3101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 14146) |
| Enumeration Date | 2009-10-08 |
| Last Update Date | 2009-10-08 |