| NPI | 1467832881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOKE A JACKSON President Owner 919-294-9440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NC 2013-00616) |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2016-03-25 |