NPI | 1730618091 |
---|---|
Entity Type | Organization |
Authorized Contact | LOPITO B BUGARIN Dr. 757-547-0588 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0101222102) |
Enumeration Date | 2017-06-08 |
Last Update Date | 2022-07-21 |