| NPI | 1235527342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTE L JACKSON Enrollment Lead 215-662-6187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VX0201X Obstetrics & Gynecology Gynecologic Oncology |
| Enumeration Date | 2014-12-26 |
| Last Update Date | 2023-08-02 |