| NPI | 1457047433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY JONES Provider Enrollment Manager 215-456-8129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2023-04-13 |
| Last Update Date | 2023-06-13 |