| NPI | 1669804159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA BORISOVNA Executive Director 703-207-4646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: VA 0101255440) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 101055521) |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2014-02-07 |