| NPI | 1508490996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAMARR BROWN Authorized Official 215-709-6440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2020-02-25 |