| NPI | 1558126664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMIT AJITKUMAR PATEL Member 919-944-4404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2024-02-19 |
| Last Update Date | 2024-02-19 |