| NPI | 1144251745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOLIBE CHIKAODILI UFONDU Owner 570-476-4161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD062479L) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD062320L) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2016-03-15 |