| NPI | 1912042920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNE D LILES Owner 252-764-2121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 201471) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2014-10-22 |