| NPI | 1720371628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH BENNETT Owner 919-553-4404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 001001310) |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2011-05-25 |