NPI | 1902149776 |
---|---|
Entity Type | Organization |
Authorized Contact | DESI-RAE HALL Delegated Official 757-251-9419 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 363L00000X Nurse Practitioner |
Enumeration Date | 2013-03-30 |
Last Update Date | 2024-08-14 |