| NPI | 1003263518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLINE DAVIS Physician Assistant 703-655-5997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110-005338) |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2023-12-28 |