NPI | 1659965457 |
---|---|
Entity Type | Organization |
Authorized Contact | TRACY WIMBERG Authorized Official 609-517-2526 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 2086S0129X |
363L00000X Nurse Practitioner | |
Enumeration Date | 2021-02-23 |
Last Update Date | 2024-09-03 |