| NPI | 1477075448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY GANDY Credentialing & Billing Manager 856-451-9395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2017-07-12 |