| NPI | 1497760052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA MARIE HANSON Nurse Practitioner 617-287-5660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MA 137670) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2020-08-22 |