| NPI | 1417568999 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AJITHA RATNAM Billing Manager 571-438-8419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 171100000X Acupuncturist | |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2020-08-10 |