| NPI | 1093371312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL C FORD Authorized Offical 484-643-2629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2024-03-04 |