| NPI | 1376618132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN ROBERT AMY Principal Member 703-366-2799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101036899) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2007-11-01 |