| NPI | 1093704025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA ANN PORTER Office Manager 804-560-8782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2020-08-22 |