| NPI | 1851761407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PACHARO SALLY NDUPU Owner/Operator 980-777-3651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 190528) |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2015-09-25 |