| NPI | 1043471212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH A WLOCH Billing Administrator 508-363-7080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: MA 446451) |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2008-06-20 |