| NPI | 1821499716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRIAM MINU FERNZ Owner 910-642-3356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 0096-00530) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 00100831) |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2019-01-04 |