| NPI | 1013109669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAM MCDONOUGH Bookkeeper 856-310-0002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NJ MA52390) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: PA 024494E) |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2011-04-11 |