| NPI | 1972120483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISHAN KASSA Founder 571-422-1663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2020-06-30 |