| NPI | 1013335371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE GEORGE GONDOR Owner/President 703-379-6020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 101223709) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2014-04-03 |