| NPI | 1407913395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIMITRIOS N SISMANIS Owner/Provider 804-934-9344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: VA 0101046909) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2022-11-04 |