| NPI | 1164851705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSIE KANE Credentialing Manager 215-932-2762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NJ 25MA06075200) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease |
| 2085R0202X Radiology, Diagnostic Radiology | |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2019-03-11 |