| NPI | 1497788327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARISSA F DOMINY Physician/Managing Member 610-409-8050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA OS-009162L) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2020-08-22 |