| NPI | 1043418882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIANNE SULLIVAN Director Of Student Health Services 508-999-8984 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2020-02-20 |