| NPI | 1245628494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AYN LARSON Physician Assistant 610-539-3221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA mao57354) |
| Enumeration Date | 2014-12-22 |
| Last Update Date | 2014-12-22 |