| NPI | 1013392687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VAJIRA GUNAWARDANE Owner 703-994-6655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D0047119) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D0047120) |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2015-07-24 |