| NPI | 1710504709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMITA SALLY GOYAL Physician 703-626-6165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2021-11-11 |