| NPI | 1548319809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL S SHU President 508-588-8034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2018-12-18 |