| NPI | 1154349975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY DAWN KERNS Office Manager 540-542-1995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VA 0101034967) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2011-03-10 |