| NPI | 1467816348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE QUEEN Financial Administrator 757-873-0338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: VA 0101051871) |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2025-03-19 |