| NPI | 1386719524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEMAL OMIDVAR President 703-751-2021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: VA 40990-01) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2017-01-30 |