| NPI | 1700257839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE PORETZ COO 703-560-7900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024172994) |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2025-09-29 |