| NPI | 1780188706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERMINA WATERS Owner 856-433-1808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NJ00301600) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2018-03-23 |