| NPI | 1164538781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE BOIMEL Office Manager 215-333-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: PA MD 015564E) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PA DC003542L) |
| 171100000X Acupuncturist (Licence: PA AK000175L) | |
| 207X00000X Orthopaedic Surgery (Licence: PA MD015723E) | |
| 363A00000X Physician Assistant (Licence: PA MA055891) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2016-09-13 |