| NPI | 1346296969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE THERESA GILSENAN Practice Owner 732-388-7300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine Sports Medicine |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2007-10-18 |