| NPI | 1982152906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA J LESTER Business Manager 804-939-7037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2016-09-19 |
| Last Update Date | 2016-09-19 |