| NPI | 1609065341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUKE SAN M.D. 434-392-6143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: VA 0101048599) |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2010-01-19 |