| NPI | 1487009767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN PADGETT Credentialing Manager 215-955-1175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2024-06-13 |