| NPI | 1063712503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN O'BRIEN Owner 617-686-9595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 190716) |
| Enumeration Date | 2010-11-01 |
| Last Update Date | 2019-05-15 |