| NPI | 1508007840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA ELIZABETH REGAN Physician 804-379-0116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101238821) |
| Enumeration Date | 2009-03-17 |
| Last Update Date | 2015-01-29 |