| NPI | 1366626814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEMA A SUNDARAM Provider 703-641-9666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MD D0044976) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101222212) |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2007-12-19 |