| NPI | 1447540604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOAIDY SOOKLALL Physician Assistant 703-668-0222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110003515) |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2011-04-08 |