| NPI | 1497887343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUGO A DAVALOS Owner 703-780-3305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: VA 0101058134) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101025745) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2008-08-25 |