| NPI | 1932496783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE GRISSMAN MCCUEN President 772-221-7620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207RP1001X Internal Medicine, Pulmonary Disease |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2021-03-31 |