NPI | 1316259013 |
---|---|
Entity Type | Organization |
Authorized Contact | SUSANNAH OGUNWO President 910-868-6477 |
Organization Subpart ? | No |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NC 200601059) |
Enumeration Date | 2010-07-09 |
Last Update Date | 2010-07-09 |