| NPI | 1164021051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER LEE Co Owner 704-904-2133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2020-10-21 |