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Individual
GERTRUDE S. LEFAVOUR
Active
Individual
GERTRUDE S. LEFAVOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MA57307
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
390002448
R R MCR
NJ
05
—
5051509
—
NJ
Enumeration date
07/15/2006
Last updated
09/19/2011
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