Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 25MB09532500 | NJ |
NPI | 1093973695 |
---|---|
Provider Name | Christina Clare Lopez |
First Address | New Brunswick, NJ 08901-1928 |
Second Address | New Brunswick, NJ 08901-1928 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2008 |
Last Update Date | 21/03/2017 |