| NPI | 1306218342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA MAE ABRINA Provider 908-209-0485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 46041) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA09476100) |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2015-10-29 |