| NPI | 1326813320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT L GREEN Owner 757-784-2320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2023-11-20 |
| Last Update Date | 2023-11-20 |