| NPI | 1023221678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA MARY SOUDER Office Manager 856-309-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA02358700) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2008-02-19 |