| NPI | 1790203719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA WHISTLEMAN Billing Specialist 703-615-5999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2017-08-30 |