| NPI | 1396201844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JI YOO LEE Gpr Resident 617-610-9928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2019-07-08 |