Individual
KAO NU LY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1718 E 4TH ST, SUITE 805, CHARLOTTE, NC 28204-3260
(704) 376-5636
(704) 376-5933
Mailing address
1718 E 4TH ST, SUITE 805, CHARLOTTE, NC 28204-3260
(704) 376-5636
(704) 376-5933
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
104223
NC
Other
Enumeration date
05/31/2006
Last updated
07/08/2007
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