| NPI | 1902112014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | UMA BASAVARAJ Business Manager 804-745-2480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: VA 0195722) |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2013-03-20 |