| NPI | 1144491754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAHLA VAKILI Md 610-331-6942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 174400000X Specialist (Licence: DE 1860) |
| 261QM2500X Clinic/Center, Medical Specialty (Licence: PA MD) | |
| Enumeration Date | 2008-03-23 |
| Last Update Date | 2008-09-03 |