| NPI | 1982717641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTE L JACKSON Enrollment Lead 215-662-6187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2020-11-20 |