| 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 |