| NPI | 1801991427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BALJIT S SIDHU Owner 804-530-0999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: VA 0101031126) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2009-07-06 |