| NPI | 1528525839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENIN J PETERS CEO 336-883-0029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 208VP0000X Pain Medicine Pain Medicine | |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner Family | |
| 207N00000X Dermatology | |
| Enumeration Date | 2019-02-22 |
| Last Update Date | 2025-03-24 |