| NPI | 1366633463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWENDOLYN DIANE HUGHES Office Manager 704-853-0173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NC F 47463) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2007-08-05 |