| NPI | 1992341127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELAINE FRATER Billing Manager 703-470-2907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease |
| 207RG0100X Internal Medicine, Gastroenterology | |
| Enumeration Date | 2019-11-22 |
| Last Update Date | 2023-08-13 |