| NPI | 1316313893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TATHAGAT CHAWALA Doctor 609-977-2315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TX 24720) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2015-08-19 |