| NPI | 1437538154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE LAGO Administrator 757-623-0526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VA 0101038741) |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2015-05-27 |