| NPI | 1457472391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB T JOSEPH President 703-273-4762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: VA 0101034461) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-08-22 |