| NPI | 1366299976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER P BULAN Pa 469-422-5899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Enumeration Date | 2024-05-01 |
| Last Update Date | 2024-05-01 |