NPI | 1609058056 |
---|---|
Entity Type | Organization |
Authorized Contact | CHRISTIAN THOR LIGE Pediatrician 252-449-5200 |
Organization Subpart ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2002-00943) |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: NC 200200943) |
363A00000X Physician Assistant (Licence: NC 0010-01994) | |
Enumeration Date | 2007-11-28 |
Last Update Date | 2020-08-05 |