| NPI | 1821718925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHILPA TRIVEDI Owner 910-584-5003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2022-08-30 |
| Last Update Date | 2023-02-17 |