| NPI | 1497079073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL BOCCONE President 703-378-3854 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2011-02-22 |