| NPI | 1427769140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA HUDSON Credentialing Coordinator 910-372-6172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2022-12-13 |
| Last Update Date | 2025-09-12 |