| NPI | 1427530583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSEY NEAL Authorized Official 757-524-2304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: VA 0101246851) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101246851) |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2018-09-12 |