| NPI | 1780476911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL RENAE DANTIS Enterprise Direct Provider Enroll 609-238-7660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2025-05-22 |
| Last Update Date | 2025-05-22 |