| NPI | 1639743750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE VINCUR Clinical Support Talent Specialist 561-815-2427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2021-05-14 |