| NPI | 1902269210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTE L JACKSON Enrollment Lead 215-662-6187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery |
| Additional Taxonomies | 208600000X Surgery |
| 2086S0129X Surgery Vascular Surgery | |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2020-11-20 |