| NPI | 1891115028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID OMBENGI Assistant Professor/Director 757-727-5455 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: VA 0201004569) |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2014-04-28 |