| NPI | 1790104487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESAM HASSAN MOUSTAFA HUSSEIN Owner 609-335-6595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: VA 0101250764) |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2014-04-10 |