| NPI | 1518784206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE BURNSIDE Healthcare Operations Manager 703-578-6030 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2024-09-24 |
| Last Update Date | 2024-09-24 |