| NPI | 1134670193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYN JOHNSON Practice Administrator 919-235-0222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NC 26088) |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2016-10-14 |