| NPI | 1104352061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELAINE FRATER Billing Manager 703-435-2227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101041163) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2023-08-13 |