| NPI | 1619415072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY LYNN ELIZABETH EICHERT Nurse Practitioner 704-516-6782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 95005931) |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2017-02-06 |