| NPI | 1659943108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ROYALL Owner 336-248-1068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LA0401X Anesthesiology Addiction Medicine |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2021-09-08 |