| NPI | 1184769200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WARREN BASIL SHAFFER Medical Director 703-212-7397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: VA 0101057177) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2023-03-07 |