| NPI | 1881707842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH JOHNSTON Executive Director 215-662-7583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207QS0010X Family Medicine, Sports Medicine | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2008-05-01 |