| NPI | 1790004570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY VEERARAJ Office Manager 215-483-6182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS-005534L) |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2010-05-19 |