| NPI | 1710705256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEISHA PERRY Physician Assistant 484-802-0307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 202D00000X Integrative Medicine |
| 207Q00000X Family Medicine | |
| 405300000X Prevention Professional | |
| Enumeration Date | 2024-10-02 |
| Last Update Date | 2024-12-03 |