| NPI | 1316453558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI A DOLINSKI Medical Director 833-278-2633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS012627) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: PA OS012627) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: PA OS012627) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: PA OS012627) | |
| Enumeration Date | 2017-12-26 |
| Last Update Date | 2017-12-26 |