| NPI | 1053478867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL NELSON DAVIDOW President 804-966-2242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: VA 0101034211) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101049601) |
| 208000000X Pediatrics (Licence: VA 0101029182) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2009-11-03 |