NPI | 1932234457 |
---|---|
Entity Type | Organization |
Authorized Contact | CARRIE ANNE FUSCA Office Manager 302-475-2700 |
Organization Subpart ? | No |
Primary Taxonomy | 111NR0400X (Licence: DE 07 50938 44) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE c1-0005266) |
Enumeration Date | 2007-02-23 |
Last Update Date | 2020-08-22 |