| NPI | 1407143910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT P HOLMAN Medical Director 703-901-6299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: VA 0101038151) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2012-01-11 |