| NPI | 1326582206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASPER I NGMONBA Group Owner 617-513-1446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 245843) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2016-12-12 |
| Last Update Date | 2023-08-07 |