| NPI | 1992011233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD AUDUBORN LONGWE Director 703-327-0955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: VA 0438000264) |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2010-08-24 |