| NPI | 1184728453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER STEVEN PETOK Administrator 704-548-1221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2022-07-21 |