| NPI | 1891422341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CODY HALL Manager 704-617-8535 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| Enumeration Date | 2022-08-04 |
| Last Update Date | 2022-08-04 |