| NPI | 1861216699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE ALLEN Authorized Official, Owner 968-273-6960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
| Enumeration Date | 2024-11-08 |
| Last Update Date | 2024-11-08 |