| NPI | 1548634678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALLU JABATI Md/Medical Director 703-497-4500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: VA 0101240114) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101240114) |
| 207R00000X Internal Medicine (Licence: VA 0101240114) | |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2015-12-01 |