| NPI | 1235546201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNICE NATALIE MUCUIS-PENHA Medical Director 804-639-8145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101249977) |
| Enumeration Date | 2014-07-22 |
| Last Update Date | 2023-03-07 |