| NPI | 1013117423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEONARDO SEQUERA FERNANDEZ President 732-500-1561 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NJ 25MA03012100) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2007-08-25 |