| NPI | 1750495420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSS MICHAEL UFBERG Medical Director 302-575-1776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: DE c10002549) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2008-04-02 |