| NPI | 1659319002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY MICKLE Credentialing Specialist 609-267-9400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2014-11-12 |