| 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 |