| NPI | 1528097755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH GILMARTIN PACKER Manager 617-519-6099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 47735) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 178677) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2020-08-22 |