| NPI | 1174868368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS SEETAL PERSAUD Owner 704-440-4689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: NC 2007-00071) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2007-00071) |
| 291U00000X Clinical Medical Laboratory | |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| Enumeration Date | 2012-11-29 |
| Last Update Date | 2022-11-03 |