| NPI | 1164993291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHIDIMMA OKOLI Administrator 508-556-1072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2019-10-04 |