| NPI | 1235682022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH CHRISTOPHER FARMER Owner 910-399-8666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 5004456) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 190386) |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2018-06-21 |