| NPI | 1407304710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERFAN IMENI KASHANI Owner/Manager 336-266-1007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NC 10505) |
| Enumeration Date | 2016-09-15 |
| Last Update Date | 2016-09-15 |