| NPI | 1538157342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA ANN BOTY Practice Administrator 484-866-9583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2017-05-10 |