NPI | 1992351910 |
---|---|
Entity Type | Organization |
Authorized Contact | TINA LOUISE HUDSON Practice Manager 910-500-6451 |
Organization Subpart ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 207R00000X Internal Medicine |
2084P0800X Psychiatry & Neurology, Psychiatry | |
363LF0000X Nurse Practitioner, Family | |
Enumeration Date | 2019-08-15 |
Last Update Date | 2020-02-11 |