| NPI | 1417680612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR PIERRE CLARK Owner 757-582-1629 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine |
| Enumeration Date | 2022-07-05 |
| Last Update Date | 2022-07-05 |