| NPI | 1679366298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIVIC VANOVER (JED) VANOVER Vice President Of Operation 856-448-3533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Enumeration Date | 2025-05-27 |
| Last Update Date | 2025-05-27 |