| NPI | 1891587036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL RENAE DANTIS Enterprise Direct Provider Enroll 609-238-7660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2025-05-22 |
| Last Update Date | 2025-05-22 |