| 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 |