| NPI | 1629220819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY D TAYLOR Member/Manager 757-596-6369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101043463) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101043463) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2009-01-13 |