| NPI | 1851909998 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NABIL TADROS Sole Member 757-354-2885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 103T00000X Psychologist |
| 207Q00000X Family Medicine | |
| 207QG0300X Family Medicine Geriatric Medicine | |
| 207R00000X Internal Medicine | |
| 207RG0300X Internal Medicine Geriatric Medicine | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 363LA2200X Nurse Practitioner Adult Health | |
| 363LG0600X Nurse Practitioner Gerontology | |
| Enumeration Date | 2020-07-15 |
| Last Update Date | 2020-07-15 |