| NPI | 1417741414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH YU Authorized Official 508-746-5300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2025-04-07 |
| Last Update Date | 2025-04-07 |