NPI | 1023147493 |
---|---|
Entity Type | Organization |
Authorized Contact | CLEMENT A. OGUNWANDE Medical Director 302-762-4545 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: DE C2-0004996) |
Enumeration Date | 2007-03-03 |
Last Update Date | 2020-08-22 |