| NPI | 1174640163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA G. BOYD Administrator 704-370-0223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: NC 73120) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2020-08-22 |