| NPI | 1134506579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK GLASSNER Family Physician 302-369-2751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: DE LG0000197) |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2015-05-06 |