NPI | 1134526015 |
---|---|
Entity Type | Organization |
Authorized Contact | SADOU IBRAHIM President 336-508-7148 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5005382) |
Enumeration Date | 2014-11-20 |
Last Update Date | 2021-04-01 |