| NPI | 1902198146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAMIL J. MORAYATI Sole Member 336-585-1212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: NC 168650) |
| Enumeration Date | 2011-05-06 |
| Last Update Date | 2011-05-06 |