| NPI | 1215429717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOUMNA DISTEFANO Managing Director 617-314-0603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: FL ME132254) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME132254) |
| 208VP0000X Pain Medicine Pain Medicine (Licence: FL ME132254) | |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2018-06-05 |