| NPI | 1720277965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HILLARY A INGRAM Office Manager 215-829-7495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: PA MD010352E) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD037959E) |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2007-10-23 |