| NPI | 1861228660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADHUSUDAN PANTHI Manager 703-485-2000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine Addiction Medicine |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2024-09-10 |
| Last Update Date | 2024-09-10 |