| NPI | 1386921534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS CLEARY Administrator 434-947-3944 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101043535) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: VA 0101036819) |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2016-01-15 |