| NPI | 1366143059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMKAR VAIDYA Sole Member 617-513-8568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 246ZN0300X Specialist/Technologist, Other, Nephrology |
| Enumeration Date | 2023-03-10 |
| Last Update Date | 2024-11-07 |