| NPI | 1366885592 |
|---|---|
| Former Name | GINA MARIE DEPOLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA10902500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD457966) |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2020-09-01 |