| NPI | 1376823237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBRISH GUPTA Manager 703-658-2650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2011-11-02 |