| NPI | 1053546572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN H SAMUEL Owner 540-316-5604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: VA 0101044708) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: VA 0101044708) |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2010-01-04 |