| NPI | 1063298008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IMANI V BRYAN Nurse Practitioner 617-943-0892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-09-06 |
| Last Update Date | 2026-04-22 |