| NPI | 1447481510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMA GAMA Owner 252-628-8300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 29064) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-00147) |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2009-10-15 |