| NPI | 1174939771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANTLEY T JOLLY Chief Medical Officer 571-224-1069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084V0102X Psychiatry & Neurology, Vascular Neurology |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease |
| 207RC0200X Internal Medicine, Critical Care Medicine | |
| 207X00000X Orthopaedic Surgery | |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2018-10-12 |