| NPI | 1215340104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY J PAULY Chief Operating Officer 617-724-7713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 202K00000X |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2014-06-09 |