| NPI | 1518573534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISSAM KHAYATA Owner 703-884-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207LC0200X Anesthesiology, Critical Care Medicine | |
| Enumeration Date | 2020-09-16 |
| Last Update Date | 2020-10-14 |