| NPI | 1154934149 |
|---|---|
| Former Name | JACOB MARDER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11008886) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL APRN11008886) |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2024-08-14 |