| NPI | 1144731225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMAR S HAQUE Owner/Authorized Official 617-855-7288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2017-10-17 |