| NPI | 1932632858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA BELLIARD Pa, Director 703-490-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0110002382) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101230929) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2022-07-21 |