| NPI | 1306187323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN A TRINIDAD President 703-709-7225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101018732) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101018732) |
| Enumeration Date | 2013-03-15 |
| Last Update Date | 2013-03-15 |