| NPI | 1003901257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY ITSKOVICH Vice President 804-364-8802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101058429) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2007-11-30 |