| NPI | 1316044225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN E OWEN Office Manager 215-751-0606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: PA MD420924) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD014096E) |
| 174400000X Specialist (Licence: PA MD025096E) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2016-07-13 |