| NPI | 1417221607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA WOODARD Credentialing/Manager 215-707-3911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2018-06-14 |