| NPI | 1437547544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTE L JACKSON Enrollment Lead 215-662-6187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine |
| Additional Taxonomies | 207PH0002X Emergency Medicine, Hospice and Palliative Medicine |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine | |
| Enumeration Date | 2014-12-26 |
| Last Update Date | 2020-11-19 |