| NPI | 1861426876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN LOVEJOY ROQUE Owner 704-658-1413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NC 95-00440) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2010-01-08 |