| NPI | 1932701497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY WILLIAMSON Authorized Official 954-501-3861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2021-10-22 |