| NPI | 1952799074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTE L JACKSON Enrollmemt Lead 215-662-6187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2020-11-20 |