| NPI | 1922496645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDMUND H. ERNST Physician 857-919-1244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MA 31992) |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2015-01-05 |