| NPI | 1861525305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANETTE M BASL Admin 757-227-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2023-10-09 |