| NPI | 1942854427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE GRISETTI Authorized Official 540-224-5405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2023-12-15 |