| NPI | 1891797049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE KENDRA FRICKE Practice Manager 919-876-7807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NC 9800209) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 31375) |
| 174400000X Specialist (Licence: NC 23576) | |
| 174400000X Specialist (Licence: NC 23533) | |
| 174400000X Specialist (Licence: NC 34410) | |
| 174400000X Specialist (Licence: NC 9500252) | |
| 174400000X Specialist (Licence: NC 200100423) | |
| 174400000X Specialist (Licence: NC 200200682) | |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2011-03-23 |