| NPI | 1922190834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON ELIA MASTOR President 704-662-6500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2010-09-16 |