| NPI | 1518419167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HONG VI TRUONG Owner 781-573-3977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: MA 253392) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 253392) |
| Enumeration Date | 2016-10-31 |
| Last Update Date | 2023-11-15 |