| NPI | 1144926429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC IMMERMAN VP 781-987-4896 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2023-02-07 |
| Last Update Date | 2023-02-07 |