| NPI | 1902250053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GILLIAN ROSALIND GUNN CLISSOLD Owner/Manager 703-675-5361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: VA 0701006150) |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2016-04-14 |