| NPI | 1770842536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELSA LAM Staff Pharmacist 703-406-7046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center Community Health (Licence: VA 0202010260) |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care (Licence: VA 0202010260) |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2012-05-14 |