| NPI | 1952609687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANCY UTOH Pediatrician 704-340-3923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NC 2005-01936) |
| Enumeration Date | 2011-03-03 |
| Last Update Date | 2011-03-03 |