| NPI | 1912065863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDULLAH AL FAROOQUE President 703-393-8883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101227765) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2020-02-03 |