| NPI | 1649483967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA D GONZALES Medical Director 804-458-1430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101026123) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2021-04-01 |