| NPI | 1770678450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL VINCENT MORO President 757-333-7625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101024391) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2009-12-31 |