| NPI | 1568916617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENID MATOS TALLMER President 919-697-5388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NC C2016204005421) |
| Enumeration Date | 2016-08-06 |
| Last Update Date | 2016-08-06 |