| NPI | 1053847699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAUSTO D FERNANDEZ Medical Director 703-417-9678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0101039947) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2017-05-02 |