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 |