| NPI | 1629023593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA GILL Cco 215-635-3151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2023-02-15 |