| NPI | 1740516897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES E FLORES Managing Member 609-581-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080S0010X Pediatrics Sports Medicine (Licence: NJ 25MA08329600) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA08329600) |
| Enumeration Date | 2009-10-26 |
| Last Update Date | 2023-03-07 |