| NPI | 1215273206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SILKY BAGGA Authorized Official 804-439-3859 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101246465) |
| Enumeration Date | 2012-12-19 |
| Last Update Date | 2014-10-27 |