| NPI | 1497216279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CONNOLLY CFO, SVP Of Admin & Treasurer 857-282-2028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2024-09-20 |