| NPI | 1235527359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTE L JACKSON Enrollment Lead 215-662-6187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207LP2900X Anesthesiology, Pain Medicine | |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2020-11-19 |