| NPI | 1194387647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE NEVADA JOHNSON Credentialing COO Rdinator 540-536-0103 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery |
| Enumeration Date | 2019-07-05 |
| Last Update Date | 2025-01-09 |