| NPI | 1851559504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMAR A BLANCO Sole Proprietor/Pediatrician 757-853-3838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101222303) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2008-05-29 |