| NPI | 1396466066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIS PRINCE Director 757-983-5475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics | |
| 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry | |
| Enumeration Date | 2022-09-09 |
| Last Update Date | 2022-09-09 |