| NPI | 1437400280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALLA F WILSON Chief Compliance Privacy & Audit Of 919-668-5161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2022-07-11 |