| NPI | 1992869689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN K DIDONATO Director Of Operations 703-647-4966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 20969-01) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2023-09-07 |