| NPI | 1851483481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOLORES D PETERSON Doctor 856-727-0999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA06096900) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2020-08-22 |