NPI | 1053913095 |
---|---|
Former Legal Business Name | GLOMAR MEDICAL LLC |
Entity Type | Organization |
Authorized Contact | NEIL J FREY Chief Executive Officer 321-543-9830 |
Organization Subpart ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
Enumeration Date | 2020-11-13 |
Last Update Date | 2020-12-03 |