| NPI | 1801168356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH LYNNE SEMONES Cns, Np 757-846-8237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: VA 001500463) |
| Additional Taxonomies | 251S00000X (Licence: VA 0024168429) |
| Enumeration Date | 2012-01-30 |
| Last Update Date | 2012-01-30 |