| NPI | 1174700421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN M RUSSO President 508-747-1560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2016-11-15 |