| NPI | 1649138041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE TRAN Authorized 703-724-1195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2026-01-13 |
| Last Update Date | 2026-01-16 |