| NPI | 1508947342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADEN MILLER CFO 757-594-4006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101043974) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2016-01-04 |