| NPI | 1720796196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE VINCUR Practice Manager 561-815-2427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology |
| 363LP2300X Nurse Practitioner Primary Care | |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2022-11-14 |