| NPI | 1841389343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SURENDRA PAL SIDHU Owner 704-480-0685 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NC 94-01034) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-08-22 |