| NPI | 1376271874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMIR GHIA General Counsel 610-730-6229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QC1800X |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2022-08-11 |
| Last Update Date | 2022-08-11 |