| NPI | 1710273503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA EILEEN WILSON Owner 732-842-7004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X (Licence: NJ 38MC00385100) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ 40QA01025400) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2011-11-09 |