| NPI | 1881600419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA BIRD Manager 703-765-4321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: VA 0101035087) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2010-02-19 |