| NPI | 1093967077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA V. KRISTIANSEN President / Physician 508-870-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 202K00000X Phlebology (Licence: MA 75153) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 75153) |
| 207RR0500X Internal Medicine Rheumatology (Licence: MA 75153) | |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2008-10-21 |