| NPI | 1750792636 |
|---|---|
| Former Name | DORENE GERALDINE BALASA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NJ00498500) |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2016-06-24 |