| NPI | 1346475076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY ELMORE Practice Manager 804-320-7139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0200X Clinical Nurse Specialist, Pediatrics (Licence: VA 0017139437) |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2009-05-26 |