| NPI | 1114609815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE L VINCUR Practice Manager 561-815-2427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2023-08-02 |
| Last Update Date | 2023-08-02 |