| NPI | 1932447463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURI RUSTAND Executive Director 703-391-2042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics | |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2013-07-09 |