| NPI | 1508190067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA M HAGELE Md 336-228-0813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: NC 6879) |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2010-02-12 |