| NPI | 1154687374 |
|---|---|
| Former Name | OMEGA DEVORA JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA09851800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME119491) |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2021-05-17 |