| NPI | 1134565997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRE GOY Director 551-996-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26nj00435700) |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2013-05-20 |