| NPI | 1801269360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN AUSTIN Administrator 571-276-2389 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2015-11-05 |