| NPI | 1043344583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK E MICHENER Treasurer 703-960-4901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101024043) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: VA 0101021474) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |