| NPI | 1063182830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELSEY ROPER Office Administrator 302-766-5368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 207LP2900X Anesthesiology, Pain Medicine | |
| 208100000X Physical Medicine & Rehabilitation | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2021-09-14 |
| Last Update Date | 2023-11-08 |