| NPI | 1841480266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY WILBUR Billing Manager 703-525-7040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101046655) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101014849) |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2013-02-13 |