| NPI | 1073648069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAG BHAWAN President 617-638-5570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0900X Dermatology, Dermatopathology (Licence: MA 22D0075241) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2020-08-22 |