| NPI | 1790097392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DAVID LIEBERMAN Owner 703-660-9333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101019492) |
| Enumeration Date | 2010-07-12 |
| Last Update Date | 2010-12-21 |