| NPI | 1073849824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOTHWELL GRAVES LEE Proprietor 703-780-7908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101221427) |
| Enumeration Date | 2009-10-29 |
| Last Update Date | 2009-10-29 |