| NPI | 1134619166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA DUDA President 703-893-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: VA 0101039385) |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2018-05-15 |