| NPI | 1720769698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE VINCUR Lwc Practice Manager 561-815-2427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| 363LG0600X Nurse Practitioner, Gerontology | |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2023-07-25 |
| Last Update Date | 2023-07-25 |