| NPI | 1225720501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE KROETSCH Practice Administrator 757-917-5246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Enumeration Date | 2023-05-24 |
| Last Update Date | 2023-06-08 |