| NPI | 1407032055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY S MILLER Office Manager 704-786-1104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery |
| 2086S0129X Surgery, Vascular Surgery | |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2012-11-29 |