| NPI | 1649666728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISHNA P MADIRAJU President 703-899-7593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110004905) |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2015-04-15 |