| NPI | 1134899784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NELDA BASUEL Practice Manager 757-710-2240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2021-09-15 |
| Last Update Date | 2021-09-15 |