| NPI | 1831605435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOLA FADIPE Owner 732-686-6030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26nj00468500) |
| Enumeration Date | 2017-12-18 |
| Last Update Date | 2017-12-18 |